Sociodemographic determinants and the age-education interaction in trust in physicians: A cross-sectional analysis of a nationally representative survey in China

Trust in physicians supports effective communication and treatment adherence, but population-level determinants in China remain poorly described, and the age-trust association may vary by education. In this cross-sectional analysis of the nationally representative 2023 Chinese General Social Survey, all respondents who answered the item on trust in physicians were included (N = 5583). High versus low trust was modeled by univariable and multivariable logistic regression with backward elimination. Generalized social trust, self-reported health, and social engagement were derived by latent class analysis, and the age × education interaction was tested by likelihood ratio test. Overall, 83.9% of respondents (4683/5583) reported high trust. In the multivariable model (n = 5372), older age (adjusted odds ratio [OR] = 0.98 per year; 95% confidence interval [CI]: 0.975-0.986), middle or high school (OR = 0.63; 95% CI: 0.528-0.754), and college-or-higher education (OR = 0.75; 95% CI: 0.575-0.972) relative to primary-or-less education, and self-media use (OR = 0.72; 95% CI: 0.600-0.872) had lower odds, whereas women (OR = 1.38; 95% CI: 1.186-1.602), higher self-rated social status (OR = 1.06 per point), and high generalized social trust (OR = 2.49; 95% CI: 2.141-2.902) had higher odds. The age × education interaction was significant (P = .021): trust declined with age in the college-or-higher and middle-or-high-school groups but not in the primary-or-less group. Trust in physicians among Chinese adults was high overall but varied with age, education, social status, generalized social trust, and self-media use; the age-related decline was concentrated among more educated adults.